The Surgical Anatomy of Ventricular Septal Defect

Journal of Cardiac SurgeryVolume 7, Issue 1 p. 17-35 The Surgical Anatomy of Ventricular Septal Defect ROBERT H. ANDERSON M.D., F.R.C.PATH., Corresponding Author ROBERT H. ANDERSON M.D., F.R.C.PATH. *Department of Paediatrics, National Heart and Lung Institute, London, United KingdomDepartment of Paediatrics, National Heart and Lung Institute, Dovehouse Street, London SW3 6LY, United Kingdom. Fax: 44–71–352–0032.Search for more papers by this authorBENSON R. WILCOX M.D., BENSON R. WILCOX M.D. **Division of Cardiothoracic Surgery, University of North Carolina, Chapel Hill, North CarolinaSearch for more papers by this author ROBERT H. ANDERSON M.D., F.R.C.PATH., Corresponding Author ROBERT H. ANDERSON M.D., F.R.C.PATH. *Department of Paediatrics, National Heart and Lung Institute, London, United KingdomDepartment of Paediatrics, National Heart and Lung Institute, Dovehouse Street, London SW3 6LY, United Kingdom. Fax: 44–71–352–0032.Search for more papers by this authorBENSON R. WILCOX M.D., BENSON R. WILCOX M.D. **Division of Cardiothoracic Surgery, University of North Carolina, Chapel Hill, North CarolinaSearch for more papers by this author First published: March 1992 https://doi.org/10.1111/j.1540-8191.1992.tb00773.xCitations: 36AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract There is still no consensus as to how best to categorize and describe interventricular communications. In a series of three reviews, a system will be described showing how the anatomical criteria chosen for categorization will also serve as a guide for surgeons as to the location of the axis responsible for atrioventricular conduction tissue. In this first review, the defects described are not complicated by overriding of arterial or atrioventricular valves and are present in hearts that have basically normal segmental connections, or have some discordant connections (complete transposition or congenitally corrected transposition). The rims of the defect categorize the boundaries to which a surgeon may place a patch. Variations in these rims produce three classes of defect: perimembranous; muscular; and doubly committed and juxtaarterial (subarterial). The second part of the classification recognizes the further variation existing with respect to the component of the morphologically right ventricle into which the defect predominantly empties. Deficient atrioventricular septation can also lead to interventricular shunting in isolation, but the morphology is then quite different from hearts with simple deficiencies of the ventricular septum. We emphasize the abnormal location of the atrioventricular node in hearts with atrioventricular, as opposed to ventricular, septal defects. References 1 Soto B, Becker AE, Moulaert AJ, et al: Classification of ventricular septal defects. Br Heart J 43: 332, 1980. 2 Van Praagh R, Geva T, Kreutzer J: Ventricular septal defects: How shall we describe, name, and classify them J Am Coll Cardiol 14: 1298, 1989. 3 Soto B, Ceballos R, Kirklin JW: Ventricular septal defects: A surgical viewpoint. J Am Coll Cardiol 14: 1291, 1989. 4 Anderson RH, Becker AE, Tynan M: Description of ventricular septal defects—Or how long is a piece of string? (Editorial review) Int J Cardiol 13: 267, 1986. 5 Kurosawa H, Imai Y, Nakazawa M, et al: Conotruncal repair of tetralogy of Fallot. 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